Drs. Todd Ponsky, Alex Casar, Alex Gibbons, and Rae Hanke review 2018 Practice Gap #2: Wilms Tumor Protocol Violations, as identified by the APSA Professional Development Committee.
Type: video · 1 min · posted 2019-06-27 Canonical: https://library.globalcastmd.com/watch/non-operative-management-of-appendicitis-2018-pediatric-surgery-practice-gap-2-1462 ## Chapters - [0:04](https://library.globalcastmd.com/watch/non-operative-management-of-appendicitis-2018-pediatric-surgery-practice-gap-2-1462?t=4) Non-Operative Management of Appendicitis as 2018 Practice Gap #2 ## Statements - "Non-operative management of perforated appendicitis has been known for a long time." (clinical) [0:19](https://library.globalcastmd.com/watch/non-operative-management-of-appendicitis-2018-pediatric-surgery-practice-gap-2-1462?t=19) - "Treating appendicitis with antibiotics had equal outcome measures compared to initial operative management." (clinical) [0:19](https://library.globalcastmd.com/watch/non-operative-management-of-appendicitis-2018-pediatric-surgery-practice-gap-2-1462?t=19) - "There was a 15% risk of recurrence of appendicitis at one-year follow-up with non-operative management." (clinical) [0:35](https://library.globalcastmd.com/watch/non-operative-management-of-appendicitis-2018-pediatric-surgery-practice-gap-2-1462?t=35) - "Non-operative management resulted in decreased hospital stays compared to operative management." (clinical) [0:35](https://library.globalcastmd.com/watch/non-operative-management-of-appendicitis-2018-pediatric-surgery-practice-gap-2-1462?t=35) - "Non-operative management resulted in decreased days of disability compared to operative management." (clinical) [0:35](https://library.globalcastmd.com/watch/non-operative-management-of-appendicitis-2018-pediatric-surgery-practice-gap-2-1462?t=35) - "Non-operative management of appendicitis is an option with risks and benefits that need to be taken into account." (guideline) [0:52](https://library.globalcastmd.com/watch/non-operative-management-of-appendicitis-2018-pediatric-surgery-practice-gap-2-1462?t=52) - "APSA was not making a flat out recommendation to start doing non-operative appendicitis." — Gibbons (opinion) [1:08](https://library.globalcastmd.com/watch/non-operative-management-of-appendicitis-2018-pediatric-surgery-practice-gap-2-1462?t=68) - "The data on non-operative appendicitis management is becoming more clear." — Gibbons (opinion) [1:14](https://library.globalcastmd.com/watch/non-operative-management-of-appendicitis-2018-pediatric-surgery-practice-gap-2-1462?t=74) - "The choice between operative and non-operative appendicitis management remains dealer's choice." — Gibbons (opinion) [1:06](https://library.globalcastmd.com/watch/non-operative-management-of-appendicitis-2018-pediatric-surgery-practice-gap-2-1462?t=66) ## Transcript Join us as we continue our review of the top 10 practice gaps of 2018, 1st presented at last year's update course by APSA's Practice Development Committee. Number two, Gibbons. So number two was talking about non-operative management of appendicitis. Um, so we've known about non-operative management of perforated appendicitis for a long time, um, but this was just kind of appendicitis in general and it emphasized that Uh, treating with antibiotics, I had kind of equal outcome measures in terms of initial operative management. There was like a 15% risk of recurrence of appendicitis at a one-year follow-up, but otherwise you had decreased hospital stays and decreased days of disability. So we're not telling you what that, that the world changed to non-operative or operative treatment of appendicitis. All we're saying with this is non-operative management is is an option. It has some risks and benefits that need to be taken into account and then make a decision accordingly. You know, my whole take on that was, it's great to see that information. I still think it's dealer's choice. I don't think a flat out recommendation was being made by ABSA to start doing non-operative appendicitis. I think it was showing that the data is becoming more clear and it's still dealer's choice on whether people do one versus the other, right. --- Not medical advice · citation policy: https://library.globalcastmd.com/ai